Was there anything more confounding, more impenetrable, Vaughan wondered, than the human mind?

✲

Dr Frank Coburn was Head of Psychiatry at the University of Saskatchewan and Vaughan a young resident surgeon at the campus’s teaching hospital. Vaughan was training under a British missionary whose specialty was the spine. The doctors Coburn and Bowen knew each other only in passing, as one more name on a door or a tag.

The life of the hospital was stimulating and purposeful and at times happier than the gruelling work and proximity to illness might suggest. Vaughan derived a deep satisfaction from mending bones spalled by illness and injury.

But his surgical prowess masked an inner turmoil – an early marriage, to an American student he’d met in Edinburgh, was failing fast. Her family had never approved of him; they refused to ascribe his quirks, as others did, to being British.

Fatherless from boyhood, Vaughan’s notion of a husband, or a prospective husband, had been formed by the movies’ square-jawed leading men. He asked himself where on earth these Bonds and Bogarts had learned their amazing insouciance, their worldliness, and presumed that the answer was the crowded and exotic bars he’d never set foot in.

He felt woefully underprepared for adult life. He tried to make sense of the 27-year-old breadwinner he had become, of the couple he formed with this young and bright American. Who was she exactly? The question weighed on him. His wife was an increasingly pressing source of bafflement: one minute she could be sitting on their sofa laughing, a beat later, tearing up. She seemed always to be telling him or pleading with him to listen. Vaughan would expend a tremendous effort to converse with her, but his remarks invariably fell flat, and when she complained he did not know why or what to say or do next. He wasn’t at all big on hugs – try as he might, he would never be Bogart to her Bacall. One frustrating evening, one of many, exasperation seized his wife and drove her to yell at him, ‘What’s wrong with you?’

What indeed? Vaughan did not know himself. He sensed himself unravelling. Some days he went out of his mind, or rather, he went further and further within it, turning this way and that, taking wrong turns, following thoughts that grew murkier, until he felt lost and afraid.

Over the months that followed, during which his discomposure steadily increased, he trudged through his hospital rounds, ate without appetite, slept fitfully, didn’t open letters, didn’t return neighbours’ waves, didn’t call on colleagues after shifts, went from slim and fair to thin and pale to gaunt and ashen.

In his weakened state the border between present and past became porous. Years of repressed mental struggles could no longer be contained. The tiniest reminder of his past caused Vaughan’s throat to contract abruptly: a stranger’s schoolmaster-like gait, or the overheard words of some argument between boys, at other times simply the scent of rain like the rain in Walton would trouble him no end. A few footsteps, a mouthful of words, a hint of a downpour – all it might take to set him off, even if they amounted to nothing more or in fact were only his imagination, which pained him all the same and just as much.

Vaughan had heard good things from his patients about Dr Coburn. But still he refrained from acting until one day after a long shift when the still lucid part of him telephoned up to the hospital’s fifth floor and told Coburn’s secretary that it was urgent.

‘I told the lady on the phone that it was for one of my orthopaedic patients,’ Vaughan explained to the psychiatrist. ‘The fact is, I’m the person who needs to consult you.’ And then, encouraged by a nod, he started to ramble. After a while his feeble voice trailed off. Eventually his unfocused eyes rose to meet the doctor’s short grey beard and thick glasses and high bald forehead.

‘You were miles away there, Vaughan.’

‘Dr Coburn?’

‘Call me Frank, Vaughan.’

✲

In Frank’s office silence was for Vaughan not a rebuke but an encouragement. In the privacy offered by its bare walls he could speak his mind. He at last unburdened himself, talking freely, taking a decade of nightmares and inexplicable headaches up to that room on the fifth floor. He described how some days he felt like he was inside a chill, black tunnel where he saw not the faintest pinprick of future light.

Frank tried him on tranylcypromine for the depression and lithium for the mood swings but far better than either of these, and without their side effects, proved to be the talking. Much of the talk returned to the English boarding school Vaughan had long attended. Vaughan described how he’d followed the other boarders’ example of putting on a brave face and voice at all times. If some of the classmates had teased him for his aloofness, many more had ignored him. With his slender, agile fingers he’d played first flute in the school orchestra – the regular rehearsals, along with the chapel and library, had kept him out of the way of most bullies.

But there had been no getting away from the masters.

‘They weren’t all rotten,’ said Vaughan. Those who taught the sciences, in particular, had found in him an able, responsive student. And often in the middle of geography he’d experienced a lightness rising in his chest like bread in a hot oven.

Taking up his pipe, drawing on it, Frank managed to get Vaughan on to the subject of the Colonel. A few times before, he had mentioned this man only to hastily switch to something else.

The Colonel had been Vaughan’s housemaster when he entered sixth form, Frank learned. Vaughan had soon become the object of this Colonel’s volcanic temper; years later, he could still hear him barking, ‘Bowen!’ The teenager would respond too slowly to some comment. Or play too quietly in the marching band. He would look the wrong way or say the wrong thing. Whatever the excuse, he’d jump out of his skin at the Colonel’s bark and flinch at what was coming. Those big, ugly, bulging veins on the fist gripping the rattan cane.

The burning sting of it.

Long, throbbing indentations on his back and buttocks.

As if the Colonel intended to pound out of him his difference.

Beat out of him everything that made Vaughan Vaughan.

The Colonel drunk on his own anger, seeing double.

When, oh when, would the whistling cane stop?

For two years, all through sixth form, far more beatings than Vaughan cared to recall. They had left their indelible mark on him. Regardless of the years, then decades, that elapsed, he would be able to relive the scene as if it were yesterday. The Colonel would be long dead by now but still he continued to cast his violent shadow over Vaughan’s thoughts. Nevertheless, and thanks to Frank, Vaughan had acquired means to discern and clamber out of the shadow.

As he spoke and Frank listened, Vaughan found himself thinking how lucky he was to be working at this hospital in Saskatchewan, among the prairies where he had spent his gap year as a farmhand. The summer before that year, by a similar twist of fate, Vaughan had discovered his vocation on a hiking holiday in Wales. A rare friend at the boarding school had accompanied him, and as they made their way across the limestone cliffs in Gower each tossed out ideas about their future.

‘I’m going to be a doctor,’ his mate said rather proudly. His father was a physician in the Royal Army Medical Corps, a man who had travelled far and wide and seen service in places that sounded brimful of adventure. The son’s evident pride could not help but touch Vaughan, and as he walked beside his friend he let himself imagine what it might be like to live and work far away overseas. The thought of healing others, he realised, appealed to him, for reasons he would be unable to explain fully to his friend or even to himself. And just like that, Vaughan began to wonder whether he too should follow in this unknown man’s footsteps. By the time he came back to Walton his decision was firm. He would abandon his plans to enrol in geography; he would bring his youthful intelligence to bear on the human body rather than on the earth. The former, he intuited, would absorb his mind most completely.

For all Frank’s efforts on the fifth floor, Vaughan’s health continued to deteriorate. After his wife moved out, he was admitted to the hospital’s psychiatric unit. Fortunately his fellow surgeons were understanding. They would wait until he could resume his service. At his lowest ebb, Vaughan became for a brief time catatonic, losing the power of speech, before improving enough to return to Frank’s office and then to his medical duties.

His recovery was slow, however, and there would be relapses. Frank, faced with Vaughan’s third admission, invited him into his home instead. Mrs Coburn made tea as the two men settled into armchairs and let the radio – As It Happens – do all the talking. Sitting back, the family’s red setter at their feet, they could have been father and son.

When Vaughan was well enough, the Coburns drove him to their summer cabin on Wakaw Lake. The green of poplars rested his eyes, the breadth of blue sky buoyed his spirits, and all around him a soothing peace reigned supreme. When Frank talked, as they strolled beside the shining lake, or in the cooler evenings as they kept warm before a crackling wood stove, he said nothing about the hospital. Instead he related light, amusing stories of his children’s time at camp.

By the end of Vaughan’s month with the Coburns, his physical and mental health had gone from strength to strength. He felt up to resuming surgery at the hospital. Frank was supportive but remained vigilant. There was still, he cautioned Vaughan, a long way to go. And indeed Vaughan might have regressed once again had Frank not called Vaughan’s mother in England and alerted her to the depth of her son’s problems.

Vaughan himself hadn’t managed to tell his mother much about his plight; whenever he’d called long-distance she’d spent half the time fretting aloud about how expensive each of the minutes must be. As soon as she came off the phone with Frank, she brought forward the flight she had already booked for the off-season. She flew over on the next available plane and for several months set up quarters in her son’s apartment.

There was only so much she could get out of him – Vaughan had never been a great talker. He was relieved when, with his permission, she took her many questions to Frank. One sunny afternoon, when she and Vaughan had come out to the cabin, Frank took her out in his canoe on the lake. They were gone for quite some time.

✲

Frank may have saved Vaughan’s life; certainly, he salvaged his career. And the young surgeon gained further stability when, following his divorce, he met and later married the operatingroom nurse with whom he would raise a son and daughter.

Vaughan, by the 1980s, was performing regular operations in a country where there were few hand and wrist specialists. He was admired by his peers; they’d witnessed him innovate techniques to mend the smallest bones and graft skin. Soon he was earning a reputation as the hand and wrist man to be consulted. Patients came to him from miles around. Quite a number were tanned farmers from the surrounding prairies, their clothes and limbs dramatically snatched by a tractor’s rotating shaft, rushed in and hoping to be reunited with a severed thumb or fingers.

‘It pretty near tore my whole hand off,’ they’d grumble in a voice husky with pain and embarrassment.

Other men, when winter came, had reached inside a clogged snowblower without thinking. Vaughan repaired each mangled hand, skilfully replanting the amputated digits, fusing together the tiny veins so that the blood went only where Mother Nature intended.

Women arrived at his hospital with different complaints. Pregnancy induced in some a tingling numbness in the fingers. Vaughan explained that the nerve passing through the wrist’s carpal tunnel had become compressed by the body’s swelling. He reassured them that this compression usually ceased in the weeks and months after delivery.

‘But if ever it persists, or worsens, then you must come back and see me,’ said Vaughan. ‘You mustn’t wait. We will find the right treatment for you.’

When presented with stiff and swollen hands by older women he never presumed, just because these patients were getting on, that their discomfort was ageing’s due. As Vaughan examined them intently and asked many thoughtful questions, it struck the women how undivided his attention was. They were unused to a surgeon taking so seriously a woman’s pain, her female ailments. Both men and women appreciated how courteous and unassuming he was.

After practising surgery for a time in Saskatoon, in 1993 Vaughan set up the Hand Program at Toronto Western Hospital. His career later took him to Stanford University and later still to Calgary.

✲

Vaughan had pictures in his mind of his white-haired mother holding court in Norfolk. She had retired there in the eighties to live near her two older sons. Vaughan and his wife and children, whenever they’d been over in the UK, had called on her. It had been a great help to him, having a wife who always knew what to say at social gatherings.

‘Oh, these are fabulous,’ he recalled his wife saying of his mother’s biscuits which were sending their crumbs everywhere.

‘Where are my manners?’ exclaimed his mother, who had been pouring milk for the tea. ‘I’ll fetch the plates.’ No, no, she didn’t need any help, she insisted, shooing her daughter-in-law away from the kitchen. Having returned with the plates, she sank low into her armchair and told them stories about the village. Then she gave an account of a cruise she had taken the summer before last – or had it been the summer before that? – to the Middle East. Vaughan knew that he ought to ask his mother some polite thing or other about her cruise but he wasn’t quite sure what.